PREDICTION OF EPILEPSY DEVELOPMENT IN CHILDREN AFTER SINGLE SEIZURE

Background. The international League against epilepsy verifies epilepsy diagnosis on the basis of a single convulsive attack providing probable recurrence, which is close to general risk of repetition of 60% and more for 10 years. The complex of factors which would enable to calculate this probability at children's age has not been developed at present. Aim. To reveal a complex of independent risk factors of development of the second attack in children with probability more than 60% within the next two years after the first episode. Material and methods. Children (n=556) aged from the birth till 17 years after the attack which developed for the first time in their lives are included into the research. Prospective observation was conducted within the next two years and then stratification was performed and two groups were created: the main group - children with epilepsy (n=447) in whom repeated attack developed; and control group of children (n=109) with a single attack. The multiple-factor analysis of a complex of independent factors is made by the ROC method of the analysis and logistic regression. Results. It is established that the complex of factors including the following parameters: the age of the child is younger than 6 years at the time of the disease manifestation, disturbances in the neurologic status of patients, pathology during the antenatal, intranatal or neonatal period, slow-wave high-amplitude activity in the background on EEG after the first attack, alterations of the brain by the results of computer tomography or magnetic resonance imaging with probability 0.931 define the forecast of a recurrence within two years after the first attack and reliable development of epilepsy (AUC = 0.931; 95% of DI [0.909; 0.954]). Conclusion. Identification of a complex of factors predicts the development of epilepsy after the postponed single seizure with probability more than 85% within two years. That qualitatively changes the concept of diagnosis and the purpose of antiepileptic medicines in children.